HomeMy WebLinkAbout0820 ~~:c~~i: ~tio~
~ a# ~orn~cile and Citizenship
~
TO Ttil: 5"I~ATI: ANU (•~uc~-r~~ ~l~A\ AtiS1;SSOR, 271430 `
St.Lucie ~
_ _T_ _ _ _ C'UUNTY, f~LORIDA:
Ti~i~ is m~~ dcclar.itic~n of Uomicilc ai~d Citir.rnship in thc Stalr of Florida ihat 1 am Cling this day in
accorJanre, and in confonnity with Scctian ~~'"_'.17, Florida Statutcs.
• ~ -
I was fonnc: rly a Icgal residrnt uf ~ and I
~ (c~~r) ' (sace~
~ % ~~f . However, I have chan ed my domicile to
msid~d at ~ g
_ (Sireel and Number)
and am and havc bcen a bona lide resident ot the State of Florida since day of
now
, 19 ~ ~ and 1 /~cside a~t - ~ • ,
__c~6~~= . (Street and Numbet)
St. Lucie County, Florida,
.
)
and this statemcnt is to be taken as my declaration ot citizenship, actua! legal residence and domicile in thc State
of Florida.
(Inseri here any pertinrnt facts, such as s~le oi pre~perty or business, or relinquishment of employment at former
domicile, removal uf famil~ to new domicile, purchase of home, ate.)
Entering children in school:~ Homestead Exemption: ~
_ `1
J
. f LED ANO RECOROEp ~a
i~. LUCIE COUNTY FLA. 4
ROCE~'OITRAf
~ CLERK C;~4WT C4URT ~
RECORQ VEk'FIFp,~,~,r,~~
~ _ OEC 78 10 39 AM'~3
~
i
~
,
a
~
; 2'71430 ~ '
~
~
¢
~ ~ _
~
~ I FURTHI:R CERTIFY that I~viU register at my local address when the registration boaks reopen, and
compiy with all other requirements of a leg:il resident of this State. ~
I FURTHf:R CERTIFY that I havc no intention to return to my former domicile, and I intend to remain in
~ ~_7`,'~ZZ~ --~f oC.C~[~ _ St . Lucie
~ , , County,
°
~ Florida, permancntly. ~ ~
~
~ ` r`~ - ` . %~~/GC~
, ~ ' ! ~ ~ •i, - ~
~ , ~ . . (Name)
~ ..t ~C,'• l
_ ~ - - ~ .,yi..v,-- ~ v ~ • ~ • ~ , wn-~
~ - - - ~ , (naa~~ N
; ~ : ' - _ . ~ - ~ ~o~t ~ ~ CC~ ; ~~~~~ct/
~ ",S,wpfh~~to ~nd sub~c~?lied bcfore mc this day of ` -
. , `o ~ . _ _ .~'~~3 ~~'~i
~ - A.D. 19-73
~ ROGER POZTRAS CLERK CIRCUIT COURT
¢s •
- ~ -
r~ s~. SppK PA6E 8~
- " ~ ~ _~C S.~ C~ _
~ . - ~E. pUtY C'
~
~ ( Iu ht caei nlrJ in dupl~ alr .~nJ ~~ri~_m.rl 1~+i1h ('I~•tk Circuit Cuurl. and Jupiicate with Ta: Assccsnt)
~ ryt
~ •
~
1 - _
'~r~~.~ . ~ ~ . _ . _ _ . _ r~._